Dental Questions: What do I do if my implant crown comes loose?

Do you have a dental implant? Have you ever noticed that the crown feels loose or that you can move it with your tongue? This sensation can be quite alarming and seems as though the entire implant is wiggling out. However, looseness is usually the result of the implant crown coming separated from the actual implant. 

Although there are a few different implant designs, they all include two pieces of metal screwed together. Over time, the forces of biting and chewing can cause these screws to work themselves loose. This is typically a issue on older implant designs, but can affect any generation.

Your best bet in solving this problem is returning to the dentist who placed the implant, or obtaining a record of what type of implant they used. This information is crucial in tightening the crown back down. Tools, hardware and design are not the same between companies and using incompatible components could ruin the implant.

After identifying the type of implant used, the treating dentist will evaluate wether or not the crown can be saved. Dental Implants are comprised of three components: the actual implant, an abutment, and an overlying crown. The abutment is essentially a metal post that the crown is screwed or cemented to. Depending on which part of the implant has failed, the entire crown may need to be removed to tighten everything back up. However, most crowns are savable and only need to be repaired or recemented once the procedure is over. If you would like to know more about implants or their maintenance, feel free to give us a call! 

Laser Dentistry

A dental laser in action.

One of the biggest developments in modern dentistry is the introduction of laser technology in the treatment of patients. 50 years ago, the idea alone would have sounded like something out of a sci-fi movie. But today, lasers have many applications in the maintenance of the teeth and gums, along with promising outlooks for the future. In our office, we use lasers for a number of treatments and want to show you why they are safe and effective dental instruments!

At it’s very core, a laser is specially concentrated beam of light that produces a small pinpoint of energy. Depending on the type of material used to create the laser beam, the energy can be optimized to cut a number of materials. For this reason, lasers have long been used in precision manufacturing for making extremely accurate cuts. In dentistry, these properties allow us to use lasers in a variety of procedures, often with less time and tissue damage involved.

The most common application of lasers in dentistry is the removal or recontouring of gum tissue. In treatments where the gums need to be adjusted, a dentist would classically utilize a sharp instrument like a scalpel. While these did a great job of cutting tissue, they would induce considerable bleeding and inflammation. Lasers match the cutting abilities of standard instruments, but also stimulate healthier healing patterns from your immune system. Because the laser “seals” the tissue as it cuts, there is less trauma to the gum tissue and shorter healing times.

At our office, we particularly capitalize on the incredible healing properties of lasers in restoring dental implants. After an implant is placed and has healed in bone, it needs to be “revealed” by cutting away any gum tissue that would interfere with attaching the crown. Traditionally, we would need one appointment to trim the gums and a second appointment to allow them time to heal before taking impressions for the lab. However, our laser system allows us to reveal the implant and take impressions in the same appointment, as the gums will heal right away with minimal inflammation.

Beyond soft tissue adjustment, lasers are utilized to provide a number of dental services, ranging from stimulating periodontal attachment to removing tooth decay. Research has also shown that lasers hold even more applications for the future. Currently, experts are working on developing a system called selective ablation, where hard tooth structure is treated by a laser that only removes demineralized areas. Although this technology is still in development, it promises a new form of extremely conservative cavity removal, as only decayed tooth will be affected by the laser.

The field of laser dentistry is still new and evolving. Likewise, information and products are being introduced to the market at a rapid pace. As with all new technologies, our office likes to evaluate the research and clinical results before incorporating them into our patient treatment. If you would like to know more about dental lasers, the types of lasers we use or why we use them, please give us a call. We pride ourselves in being knowledgeable in all the current topics in dentistry and dental services!

Dental Implants Thousand Oaks

Lost teeth can be replaced by a number of different dental treatments, including implants, removable dentures, and bridges.  Implants are the most technologically advanced treatment option and act the most like natural teeth.  Dental implants are bio-compatible titanium alloy cylinders that act as a root replacement for a missing tooth.   In their current form, dental implants have been around since the late 1970s when a Swedish orthopedist named Dr. Branemark developed them for dentistry. 

Today dental implants are the preferred course of treatment for replacing a single missing tooth.  They are similar in cost to doing a bridge and far more comfortable than wearing a removable appliance such as a partial denture.  In addition, unlike a bridge, dental implants do not require disturbing the tooth structure of surrounding teeth. 

According to the Academy of Osseointegration website, the long term success rate of implants remaining stabile in the bone is 90%.  A study published in Clinical Oral Implants Research (July 2010) showed a 16 year survival rate of 83%.  In either case, implants have an amazing long term success rate, that makes them a predictable option to replace a missing tooth. 

Implants have become a billion dollar industry.  Two of the leading implant manufacturers, Nobel Biocare and Straumann each reported yearly revenue in 2013 and 2012 respectively of over 780 million US dollars.  In my office I have been placing dental implants since 2007.  I have chosen to place Straumann implants, because they are an industry leading company that has been developing implants in Switzerland since 1974.  They produce a high quality and consistent product, including the implant and all of the parts that connect to the implant that allow us to restore the implant with a prosthetic tooth. 

As a general dentist, I enjoy placing implants in my office because I know where the ideal placement is so that I can restore the implant with an ideally fitting and functioning crown.  The actual surgery of placing the implant isn’t much different than drilling an ideal hole in a tooth to fix a cavity.  Implants are placed by surgically making a small incision in the tissue, followed by drilling a hole similar in size to the implant, and then using a torque wrench to screw the implant in place.  The entire procedure is done with local anesthesia in under an hour.  Patients have told me that having an implant placed is less traumatic than having a tooth removed, and the recovery isn’t much different than having a filling placed. 

After a tooth is lost, it is ideal to wait four months for the bone to heal before placing the implant.  It takes an additional four months once an implant is placed for it to osseointegrate in the bone and for the permanent crown to be placed.  So from the initial tooth loss it takes eight months for the procedure to be completed.

In restoring the implant, there are a couple of steps.  We take an impression of the location of the implant.  Then my lab fabricates a custom abutment, which replicates the missing part of the tooth that sticks above the gum tissue.  These abutments are made of either a high noble metal, titanium or zirconia and they are screwed onto the implant.  Finally a traditional crown is made to attach to the abutment.

Patients frequently ask about the cost and timeline for dental implants.  To restore a single missing tooth with a dental implant, abutment, and crown, the cost is approximately $3500.  Implants are most predictable in their long term success when they are given the proper amount of time for the bone to integrate and heal to the implant.  When advertisements are made for implants that cost less or take less time, it generally involves using less quality implants and connecting parts.  I believe in using industry leading parts, custom abutments, and quality local labs to complete all of my implant cases.

Kari Ann Hong, DDS
1000 Newbury Rd. #190
Thousand Oaks, CA 91320
www.thousandoaksfamilydentistry.com